Post on 29-May-2020
Payerpath UB-04 Training
Nevada Medicaid Provider Training
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What will be covered…
• Benefits of electronic claim submission
• Required enrollment forms
• Submission contact information
• Signing on to Allscripts-Payerpath
• Creating and viewing claims
• Submitting a UB-04 claim form
• Copy claims feature
• View the remittance advice
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Electronic Data Interchange (EDI)
• Eliminates supply costs• Preprinted forms
• Envelopes and postage
• Allscripts-Payerpath claim submission is free
• Eliminates time-consuming processes and reduces claim errors• Document sorting and filing
• Built-in validation checks
• Quicker processing and notification• Check claim status within 48 hours of submission
www.medicaid.nv.gov
Scroll down to EDI Enrollment Forms
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EDI Enrollment Documents
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Allscripts-Payerpath Enrollment Documents
• Enrolled providers may submit electronic Nevada Medicaid and Nevada Check Up
claims free of charge through Allscripts-Payerpath.
• Simply complete Service Center Authorization form (FA-37) and the Allscripts-Payerpath
Enrollment form (FA-39) located on the Electronic Claims/EDI webpage and submit your
documents for processing.
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Required Registration Forms
• Enrollment forms for Allscripts-Payerpath: www.medicaid.nv.gov
• Send in one FA-37 (Service Center Authorization) form for each Group National
Provider Identifier/Atypical Provider Identifier (NPI/API) unless billing each rendering
provider as an individual
AND
• Send in one FA-39 (Payerpath Enrollment) form and include the names of all those who
will be using this Payerpath account
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Form Submission and Contact Information
• Completed registration forms are to be mailed to:
Nevada Medicaid
P.O. Box 30042
Reno, Nevada 89520-3042
• Faxed to: 775-335-8502
• Emailed to: NVMMIS.EDIsupport@dxc.com
• Upload forms to: www.medicaid.nv.gov then login to Electronic Verification System (EVS)
website to upload documents
• For assistance, call 1-877-638-3472, option 2, select then option 0 and then select option
3 to speak with an EDI Coordinator
Getting Started
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Accessing Payerpath On the Electronic Claims/EDI webpage, scroll down to the Allscripts-Payerpath link.
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Login Page
Enter Customer Name
Enter User Name
Enter Password
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Welcome Page
Select New Messages
Select New Remit Reports
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Welcome Page
Please select Knowledge Center.
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Knowledge Center
This is the Knowledge Center.
Please select General Information.
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Training Materials Claims
This is the General Information.
Please select Institutional User Manual.
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Payerpath Institutional Claims User Guide
This is the Institutional Claims User Guide.
Please select the Save icon or Print icon in the top left corner.
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Learning Check
1. What is the website address you would use to directly login to Allscripts-Payerpath?
2. What is one of the first things you should do when getting started with Allscripts-Payerpath?
a. Print your remittance advice
b. Submit a claim
c. Copy a claim
d. Visit the Knowledge Center
3. Which documents should you review and/or print?
a. Payerpath Institutional UB COB Instructions
b. Payerpath Institutional User Guide
c. All of the above
UB-04 Claim Form Submission
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Submitting Institutional Claim Form
From the Welcome Page, select Claims then scroll down to the View Claims options
Customer SupportCall 877-638-3472, option 2, then option 0, then option 3 | Mon-Fri 8 a.m. to 5 p.m. PT | Email: nvmmis.edisupport@dxc.com
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Claims List Filter
SelectInstitutional
Choose from Untransmitted (claims not yet sent) or Transmitted (claims that have been sent)
Select Apply Filter
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Untransmitted Claims List
Untransmitted claims are retained in the system for 90 days.
Previously entered claims will be displayed on the Untransmitted Claims List. Claims must be in a “P” (Passed) status before they can be sent.
Select “V” for View
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How to Create a Claim Template
Scroll down to the bottom of the page and select Copy
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How to Create a Claim Template
Select OK
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How to Create a Claim
Key in all of the Red highlighted sections on the UB-04 claim form
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How to Create a Claim
Scroll down to the bottom of the page and select Save & Run Edits to save all changes
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How to Create a Claim
All the updates will be saved to the document and will no longer be highlighted in Red
Any new edits will be highlighted in Red
Enter new requirements on UB-04 form
Field 6 will be highlighted until all data is completed on the UB-04 claim form
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How to Create a Claim
Scroll down to the bottom of the page and select Save & Run Edits to save all changes
Key in all of the Red highlighted sections on the UB-04 claim form
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How to Create a Claim
A pop up message will advise Total ChargeLinewith Revenue Code 001 or 0001 is required
After your last revenue line please enter 001 in Field 42 and total Charges in field 47
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How to Create a Claim
Scroll down to the bottom of the page and select Save & Run Edits to save all changes
Key in the last revenue line
Enter 001 in Field 42 and total Charges in field 47
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How to Create a Claim
Any new edits will be highlighted in Red
Enter new requirements on the UB-04 form
Enter Service Units in Field 46
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How to Create a Claim
Scroll down to the bottom of the page and select Save & Run Edits to save all changes
Any new edits will be highlighted in Red
Enter new requirements on the UB-04 form
Enter Service units in Field 46
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How to Create a Claim
All the updates will be saved to the document and will no longer be highlighted in Red
Scroll down to the next Red highlighted fields
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How to Create a Claim
Enter the Estimated Amount Due - Payer
Key in all of the Red highlighted sections on the UB-04 claim form
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How to Create a Claim
Scroll down to the bottom of the page and select Save & Run Edits to save all changes
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How to Create a Claim
Any new edits will be highlighted in Red
Enter new requirements on the UB-04 form
Enter Service Medicaid ID number in Field 60
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How to Create a Claim
Scroll down to the bottom of the page and select Save & Run Edits to save all changes
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How to Create a Claim
Once the page is saved, please scroll up to the top of the page and look for the tab that reads Electronic Fields
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How to Create a Claim
Click on the Electronic Fields tab at the top of the page to enter the Insured’s Date of Birth
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How to Create a Claim
Enter Insured’s Date of Birth
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How to Create a Claim
Scroll down to the bottom of the page and select Save & Run Edits to save all changes
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How to Mark Your Claim for Send
Scroll down to the bottom of the page and select Send to mark the claim for processing. Once the claim has been sent you are unable to make any changes the claim form.
Scroll down to the bottom to confirm claim has no additional edits by locating No Errors on claim
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How to Print & Save Your Claim
Scroll down to the bottom of the page and select the Print button to print a copy of the claim form
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How to Print & Save Your Claim
A pop up window will appear. Select the UB-04 Form (ICD-10)-With Form, then select the Print button.
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How to Print & Save Your Claim
A pop up window will show the UB-04 Form (ICD-10)-With Form in a Report Viewer, then select the Preview button
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How to Print & Save Your Claim
A pop up window will show the UB-04 Form (ICD-10)-With Form in a PDF document, then select the Save button or the Print button
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How to Print & Save Your Claim
To close the pop up window for the PDF document, select the Red X in the right hand corner of the window
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How to Print & Save Your Claim
To close the pop up window for the Report Viewer document, select the Red X in the right hand corner of the window
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Back to Untransmitted Claims List
Scroll up to the top of page and select the button that reads Back to List
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Untransmitted Claims List
Other options available from the Untransmitted Claims List include selecting any claims in a Passed Status to Print or mark for Send
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Untransmitted Claims List
Other options available from the Untransmitted Claims List include selecting any claims in a Passed Status to Print or mark for Send
Other options available from the Untransmitted Claims List include selecting any claims to Print
Viewing Remittance Advice
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Remittance Detail
Select Reports
Select Remittance
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Remittance Report Filter
Select Report Dates
Select Apply Filter
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Remittance Detail List
Select View
Check Data will be listed: Payer, NPI, Check No, Check Amount, Check Date, Received Date and Status
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Remittance Advice
Name of InsuredPat AccountInsurance ID NumberService Date Procedure Code
Claim Number/ICN
Total Billed AmountTotal Provider Paid Amount
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Learning Check
1. You should always copy the template before entering claim information?
a. Yes
b. No
2. From the Welcome page, where do you go to start your submission of a claim?
a. Tools
b. Reports
c. Claims
d. Help
3. Will your claim be automatically submitted once it’s in a passed status?
a. Yes
b. No
Nevada Medicaid Contact Information
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EDI Help Desk
Phone: (877) 638-3472 (select option 2, then select option 0, then select 3)
Email NVMMIS.EDIsupport@dxc.com
Mailing Address
Nevada Medicaid
EDI Coordinator
P.O. Box 30042
Reno, NV 89520-3042
Nevada Provider Training
Email NevadaProviderTraining@dxc.com
Thank you
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